Liver cancer is a disease that develops in the liver, a vital organ responsible for filtering toxins, supporting digestion, and regulating the body’s metabolism. The most common type of liver cancer is hepatocellular carcinoma (HCC), which typically occurs in patients with chronic liver conditions such as cirrhosis.
In its early stages, liver cancer often does not cause specific symptoms. As a result, many patients are diagnosed only when the disease has progressed to an advanced stage, making treatment more challenging.
Today, the modern therapy High-Intensity Focused Ultrasound (HIFU) is available at Mandaya Royal Puri Hospital as a new treatment option for hepatocellular carcinoma (HCC), including in patients with cirrhosis. The procedure is performed by Dr. Sugianto Santoso, Sp.Rad(K)RI, a consultant interventional radiologist.
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What Is HIFU?
HIFU is a minimally invasive, incision-free procedure that uses high-intensity ultrasound waves to destroy tumor tissue. The ultrasound energy is precisely focused on the cancerous area, generating heat that damages tumor cells without the need for open surgery.
With this approach, tumors can be gradually destroyed while the surrounding healthy tissue remains protected.
Eligibility Criteria for Liver Cancer Patients to Undergo HIFU
HIFU therapy is generally considered for patients with the following conditions:
1. Patients with Hepatocellular Carcinoma (HCC)
HIFU is most commonly used for primary liver cancer (HCC). This method is considered effective because it can destroy tumors without major surgery.
2. Patients with Advanced Cirrhosis, Including Those with Ascites
Even in patients with severe cirrhosis accompanied by fluid accumulation in the abdominal cavity (ascites) or around the lungs (pleural effusion), HIFU may still be a treatment option, depending on a comprehensive medical evaluation.
3. Tumors Clearly Visible on Ultrasound
Because the procedure is performed under imaging guidance, tumors that can be clearly visualized on ultrasound are more suitable for HIFU treatment.
4. Tumors in Challenging Locations
Some tumors are located in difficult areas, such as near the diaphragm, ribs, stomach, intestines, gallbladder, heart, major blood vessels, or bile ducts. With specialized techniques and careful preparation, HIFU can still be performed safely and precisely in these situations.
How HIFU Works for Liver Cancer with Cirrhosis
In simple terms, HIFU works as follows:
1. No Incisions Required
The HIFU device is placed on the skin surface and delivers ultrasound waves from outside the body directly to the tumor.
2. Energy Focused on the Tumor
Special-frequency waves are concentrated precisely on the cancerous tissue.
3. Increased Tumor Temperature
When the energy is concentrated, the temperature in the targeted area can rise above 60°C.
4. Thermal Ablation of Cancer Cells
The high heat causes permanent damage to cancer cells, leading to their destruction.
5. Protection of Healthy Liver Tissue
Because the heat is focused on a specific point, the surrounding liver tissue remains relatively safe. This is especially important for patients with cirrhosis, whose liver function is already compromised.
Clinical Study Results on HIFU for Liver Cancer
Several studies have shown promising results regarding the use of HIFU in HCC patients with cirrhosis.
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No Major Complications Observed
In a study involving 55 patients with large tumors (average diameter of approximately 8 cm) and cirrhosis, HIFU therapy did not result in major complications during or after the procedure.
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Complete Ablation Rate of 69.2%
Among patients who underwent further evaluation, approximately 69.2% achieved complete tumor ablation.
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Encouraging Survival Rates
Data showed a survival rate of approximately 61.5% at 12 months and 35.3% at 18 months after therapy.
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Combination of HIFU and TACE Shows More Optimal Results
Another study demonstrated that combining HIFU with Transarterial Chemoembolization (TACE) resulted in better survival rates compared to TACE alone in patients with advanced liver cancer.
These findings suggest that HIFU, whether used as a standalone therapy or combined with other treatments, has the potential to become an effective alternative for treating hepatocellular carcinoma (HCC) with cirrhosis.
Interventional Radiology HIFU Specialist at Mandaya Royal Puri Hospital
Dr. Sugianto Santoso, Sp.Rad(K)RI, is a radiology specialist with a subspecialty in interventional radiology and extensive experience in minimally invasive procedures for cancer diagnosis and treatment, including liver cancer.
In his practice, he utilizes advanced medical imaging technologies such as ultrasound, CT scan, MRI, and fluoroscopy to ensure accurate and safe procedures. In addition to HIFU, he is also skilled in performing TACE, Radiofrequency Ablation (RFA), and Microwave Ablation to destroy tumors without major surgery.
Dr. Sugianto completed his medical degree at Maranatha Christian University in Bandung and his radiology specialist training at the University of Indonesia.
Dr. Sugianto Santoso, Sp.Rad, (K)RI is available at RS Mandaya Royal Puri on:
- Tuesday: 4:00 PM – 8:00 PM (WIB)
- Thursday: 4:00 PM – 8:00 PM (WIB)
To make your visit easier, you can use the WhatsApp Chat feature, Book Appointment service, or download the Care Dokter app from Google Play and the App Store to check queue numbers and access complete information.
